DETERMINATION OF SOMATIC, NEUROLOGICAL AND PSYCHO-EMOTIONAL MANIFESTATIONS OF THE ACUTE AND POSTCOVID PERIOD IN PATIENTS WITH A MILD COURSE OF COVID-19 IN WARTIME.

OBJECTIVE: The aim: To analyze the typical symptom complex at the stage of COVID-19 acute phase in the systemic relationship with somatic, psychosomatic, and neurological manifestations. PATIENTS AND METHODS: Materials and methods: The collection of primary material was performed by clinical-anamnestic method, laboratory, and sociological examination of patients treated out patiently. Summarizing of the results was performed according to the analysis of 100 completed cases of COVID-19 in patients aged 35-45 years (50 men and 50 women) who had no concomitant chronic pathology, and patients did not receive any vaccine dose before the disease (acute COVID-19) and during the next follow-up period (6 months). RESULTS: Results: The data of the analysis allowed us to make a grounded conclusion about the syndromic heterogeneity of COVID 19 in a standardized patients group with a mild course. CONCLUSION: Conclusions: the highest number of symptoms in the postcovid period by frequency, polymorphism, and life quality impact was found in the group of patients with subjectively tolerate acute COVID-19 most easily. Patients whose acute episode meets the mild criteria have pronounced neurological and psychoemotional manifestations during the postcovid period.

PRACTICAL ASPECTS AND RESULTS OF COGNITIVE THERAPY IN THE EARLY RECOVERY PERIOD OF ISCHEMIC STROKE.

OBJECTIVE: The aim: To determine the impact of cognitive training on the degree of cognitive functions recovery and quality of life in the early recovery period of ischemic stroke. PATIENTS AND METHODS: Materials and methods: 108 patients with cerebral infarction were examined outpatiently, follow-up from 1 to 3 months from the onset of the disease. Basic assessment methods: screening index of cognitive disorders according to the Montreal Cognitive Assessment Scale (MoCA), SF-36 questionnaire. RESULTS: Results and Conclusions: Comprehensive rehabilitation measures for the early recovery period of ischemic stroke achieve improvement of the cognitive sphere: a significant increase in the average score on the Montreal scale of cognitive functions assessment (MoCA scale) in both observation groups.

Mechanisms of insomnia formation with gastroesophageal reflux disease, taking into account the psychosomatic status in young people.

OBJECTIVE: The aim: The work is aimed to study the formation mechanisms of sleep disturbances with GERD based on the determination of melatonin and serotonin indicators in the blood, psychosomatic status and quality of sleep, motor-secretory function of the esophagus and stomach in young people. PATIENTS AND METHODS: Materials and methods: All 63 patients were with non-erosive GERD and insomnia. Among them, 32 with inhibitory personality type and 31 with excitable personality type. The control group is 25 people. Questionnaires were used to determine the quality of sleep, quality of life, state of the nervous system, ultrasound, stomach acidity, level of melatonin and serotonin. RESULTS: Results: In patients with inhibitory personality type, depressive disorders, lower sleep quality and quality of life were more pronounced, and in patients with excitable type, increased levels of reactive and personal anxiety and pronounced motor-secretory disorders. CONCLUSION: Conclusions:Psychosomatic disorders in GERD have a significant impact not only on the quality of sleep, quality of life, the level of melatonin and serotonin, the regulation of the secretory and motor functions of the stomach, but they are one of the links in the pathogenetic mechanism of the formation of both GERD and insomnia with it.

Non-pharmacological treatment of chronic neck-shoulder myofascial pain in patients with forward head posture.

OBJECTIVE: Introduction: Today, chronic pain remains a pressing medical and socio-economic problem, despite the rapid development of medical technologies, the presence of a vast arsenal of drug and non-drug treatments. Estimates for chronic pain prevalence ranged from 8% to 60%. At the same time, about 40% of patients report insufficient effectiveness in the treatment of chronic pain syndrome. The aim of the study was to compare the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP. PATIENTS AND METHODS: Materials and methods: 87 patients (mean age - 39±4,9 years) with chronic neck-shoulder myofascial pain and FHP were randomly assigned to 2 treatment groups. Group 1 received a biomechanical correction, DN, TrPs-pressure release. Group 2 - therapeutic exercises, DN, TrPs-pressure release. Study protocol included CVA-measurement, assessment of pain intensity with VAS, assessment of QoL using MOS SF-36. RESULTS: Results: increase of CVA (59,07°±1,41 in the 1st group, and 51,2°±2,01 in the 2nd group (p=0,036)), decrease of pain and decrease of influence of neck pain in performance of everyday activities, the improvement of QoL immediately after treatment occurred in both groups. However, after 3 months of therapy, 1-st group revealed more improvement than the 2-nd. CONCLUSION: Conclusion: Comparison of the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP demonstrated no significant differences between the therapeutic approaches in the short term. In the medium term, the inclusion of biomechanical correction in the treatment protocol demonstrated higher efficiency compared with the combination of therapeutic exercises, DN and TrPs-pressure release.

Features of estimation of muscle tone and functional state of spinal motor neurons in patients with post-stroke spasticity on a background of a pharmacological correction

Introduction: Recent scientific research has shown that post-stroke spasticity occurs in 20-30 % of cases. Very often spasticity impairs and gives discomfort for a person who has it. In that case it should be managed and relieved. The aim: To conduct standardization of determination of degrees of spasticity by means of foregoing scales and methodologies with further comparison of their sensitiveness and objectivity of the obtained data. Material and methods: 24 patients with post-stroke spasticity were treated during 14 days using the same centrally acting anti-spastic drug (oral tolperisone hydrochloride). The average duration of spasticity was 25 months (minimum 20 months and maximum 36 months). 24 patients were rated on the Modified Ashworth Scale and of those patients: 1 was rated stage "1", 5 ­ stage "1+", 7 ­ stage "2", 7 ­ stage "3" and 3 patients were rated stage "4". Assessment of muscle tone for each patient was performed daily during morning round. At our study we have used the Modified Ashworth Scale, the Modified Tardieu Scale, Functional Independence Measure, Visual Analog Scale for Pain and some parameters from ENMG study (Hoffmann's reflex and F/M max measured for ulnar nerve at the side of paresis). The results were statistically analyzed through Microsoft Excel 2010 using Student's method and Spearman's rank correlation coefficient. P value less that 0,05 was considered as a significant level. Results: According to collected statistics we can advise for control of treatment of post-stroke spasticity using ENMG parameters and Visual Analog Scale for Pain during first 7 days of treatment, using of Modified Ashworth Scale and Tardieu Scale is more appropriate starting on 7th day of taking anti-spastic medications. Unfortunately, according to gathered statistics there is no correlation between Modified Ashworth Scale and parameters of ENMG. Conclusions: For the estimation of efficiency of post-stroke spasticity treatment in the first 7 days of the therapy more informative are electroneuromyographic parameters and Visual Analog Scale. Muscle tone assessment scales (Modified Ashworth Scale and Modified Tardieu Scale) for the monitoring of dynamic changes of efficiency of the treatment can be recommended beginning from the seventh day of the therapy.